In a normal heart, regular electrical impulses keep the heart beating in a measured rhythm. If this electrical system is disturbed, the heart rhythm can be disrupted, causing an arrhythmia. By accurately diagnosing the precise cause of an arrhythmia, it is possible to select the best possible treatment.
Arrhythmias, by their very nature, are unpredictable and intermittent, which makes it unlikely that an electrocardiogram, or EKG, will pinpoint the underlying electrical pathway problem. Even longer tests, such as Holter monitoring, may not capture an event.
For patients with symptoms of heart rhythm disorders, electrophysiology (EP) studies are often recommended.
During an EP study, a specially trained cardiologist may provoke arrhythmia events. As a result, EP studies can:
- Diagnose the source of arrhythmia symptoms
- Evaluate the effectiveness of certain medications
- Predict the risk of a future cardiac event, such as Sudden Cardiac Death
- Assess the need for an implantable device (a pacemaker) or treatment procedure (radio frequency catheter ablation)
An EP study is performed with the patient under local anesthesia and conscious sedation (twilight sleep). A narrow, flexible tube called a catheter is inserted into a blood vessel and the heart. Once the catheter reaches the heart, electrodes at its tip gather data.
After the damaged site or sites are confirmed, the physician may administer different medications or electrical impulses to determine their ability to halt the arrhythmia and restore normal heart rhythm. Based on this data, as well as information gathered before the study, sometimes the specialist will proceed to place an implantable pacemaker or defibrillator. The procedure takes about two hours. The patient remains still for four to six hours afterward to ensure the entry point incision begins to heal properly.
Preparing for an EP Exam
Your cardiologist will determine if you need EP studies completed. Your doctor will provide you with a referral and a consultation will be established with the EP physician. The EP physician will then take care of scheduling your case and the EP team will call you with all the information you need to prepare for the procedure and answer any questions.
